The first experience of using multimodal low-opioid anesthesia for coronary artery bypass surgery

Abstract

The article deals with the study on the effectiveness of multimodal low-opioid anesthesia during coronary artery bypass surgery. The study included 11 patients aged 69.5 ± 6.2 years, who underwent coronary artery bypass surgery. All patients were operated under general anesthesia. The average duration of anesthesia was 257.4 ± 19.1 min. Induction included propofol (1.52 ± 0.05 mg/kg), fentanyl (1–1.5 μg/kg), pipecuronium bromide (0.1 mg/kg). Maintenance of anesthesia: sevoflurane (1.5–2 minimum alveolar concentration), keta­mine (0.5 mg/kg), lidocaine 1 mg/kg bolus, with continuous infusion (1.5–2 mg/kg/h). The average dose of fentanyl used for the entire period of anesthetic management was 1.09 ± 0.03 μg/kg/h (358.3 ± 27.1 μg during surgery). The researches have shown that multimodal low-opioid anesthesia provides an adequate analgesic effect and allows refusing intraoperative use of high doses of narcotic analgesics when performing highly traumatic operations, which is confirmed by the absence of hemodynamic and endocrine-metabolic shifts during its use.